Despite significant efforts, African Americans continue to experience excess rates of morbidity and mortality from cancer compared to individuals from other ethnic and racial groups. Primary access to cancer screening services plays an important role in reducing racial disparities in cancer outcomes; however, data from national surveys demonstrate that some individuals continue to be underserved. Even though free and low cost screening programs have been developed, these services may be under-utilized among African Americans. Increasingly, navigator programs for cancer care are being developed and evaluated in clinical settings to facilitate access to cancer diagnosis and treatment. However, to be effective at reducing cancer disparities in underserved populations, navigator programs are needed at all phases of the cancer care continuum, including early detection, and should be available in community settings. In response to }PAR-07-283, Community Participation in Research,} we propose to develop and evaluate a community-based navigator program for cancer care through an established academic-community partnership consisting of investigators from the University of Pennsylvania and representatives from community-based organizations who are participating in the West Philadelphia Consortium to Address Disparities. The specific aims of the study are as follows: (1) to develop and implement a community-based navigation (CBN) program for cancer control in a medically underserved population; (2) evaluate uptake of the CBN program among African Americans based on socioeconomic factors, psychological variables, and sociocultural factors; and (3) evaluate the effects of the program in terms of perceived barriers and benefits to cancer screening. We predict that women and those with greater knowledge about cancer and perceived risk will be most likely to participate in the CBN program. We also predict that sociocultural factors (e.g., cultural beliefs and values and social support) will be associated with participation such that individuals with lower levels of present temporal orientation and those with less social support will be most likely to participate in the program. Further, we hypothesize that compared to those who decline, individuals who participate in the CBN program will report greater increases in adherence to cancer screening recommendations and perceived benefits to screening and greater reductions in perceived barriers. This study will be implemented in two phases. In Phase I, we will develop a community- based navigator program that targets African American men and women ages 50 to 75 in West Philadelphia through an academic-community partnership and in Phase II, we will identify predictors of program adoption and will evaluate the impact of this program among community residents. This study will provide empirical data on the psychological and behavioral impact of a community-based approach for facilitating primary access to cancer care services in a medically underserved population. Cancer is the second leading cause of death among African Americans. This study will provide empirical data on individuals who are most and least likely to use a community-based approach for facilitating primary access to cancer screening and will also evaluate the psychological and behavioral impact of this approach in a medically underserved population. PUBLIC HEALTH RELEVANCE: Cancer is the second leading cause of death among African Americans. This study will provide empirical data on individuals who are most and least likely to use a community-based approach for facilitating primary access to cancer screening and will also evaluate the psychological and behavioral impact of this approach in a medically underserved population.